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Demystifying doctors: Stormy Weather: Afterlife

2003; BMJ; Volume: 327; Issue: 7423 Linguagem: Inglês

10.1136/bmj.327.7423.1114

0959-8138

Khalid Ali,

Empathy and Medical Education

Cinema has rarely tackled the sensitive subject of doctor-patient relationships. While the ethical and behavioural issues about how doctors relate to patients and vice versa have long seemed appropriate stuff for television drama and soap, they do not seem to lend themselves to blockbuster action. However, two films shown at the 47th London Film Festival last week, Stormy Weather and Afterlife, both sought to examine the fragile interdependence between doctors and patients that is at the heart of medicine.​medicine. Figure 1 Stormy Weather shows both doctor and patient as vulnerable Credit: image.net In Stormy Weather, Icelandic director Solveig Anspach explores the close relationship between a psychiatrist, Dora (Elodie Bouchez), and a mysterious, uncommunicative patient, Cora (Didda Jonsdottir), who is given to sudden and violent tantrums. Dora is intrigued and takes a personal, almost possessive, interest in her patient, spending long hours after work talking about her intimate childhood memories, trying to break through the barrier of silence. When Cora is transferred back to a small isolated island in Iceland, Dora follows her, and a series of traumatic events unfold. Both doctor and patient are presented as vulnerable human beings who need each other. Most poignantly this is seen, in a reversal of standard roles, when the patient holds the doctor's hand to comfort her. The film suggests that doctors may depend on patients in order to give themselves a sense of purpose, achievement, and fulfilment. Similarly Afterlife, which deals with the subject of euthanasia, raises issues about doctor-patient relationships as well as doctors' accountability to the general public. The main character is an ambitious journalist, Kenny (Kevin McKidd), who is investigating an eminent professor's involvement in a case of euthanasia. While interviewing the professor, Kevin finds him to be torn between his beliefs in patients' rights to decide their own circumstances of death and his own fear of public scrutiny and condemnation. Kevin's investigation is interrupted when he is summoned back to the family home to look after his sister Roberta (Paula Sage), who has Down's syndrome. The film is positive in its portrayal of Down's syndrome, and Roberta is superbly acted as a funny, humorous, and lovable character. Kevin's mother's general practitioner is presented as a caring doctor, paying home visits and stressing quality of life as an important factor in making treatment decisions. Afterlife asks serious questions about doctors' responsibilities towards their patients in deciding between different treatment options, and when to withhold or withdraw treatment. Organisations such as the General Medical Council, the Royal College of Nursing, and the BMA have all issued guidelines on withholding treatment and on euthanasia. This film opens these ethical dilemmas to public debate. Both these films make astute, yet unsentimental observations about the doctor-patient relationship. They help viewers see doctors as human beings as well as professionals—no longer as untouchables in an ivory tower— and as such they are to be welcomed in view of growing public concerns regarding clinical malpractice. There is a need for people to understand doctors' views and limitations—films such as these help to demystify the image of the doctor.